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With the conclusion of the 2012 election cycle, retail pharmacy operators have received a definitive answer to one of the biggest questions facing the industry.
The reelection of President Obama and continued Democratic control of the Senate guarantee that implementation of the Affordable Care Act will continue, bringing some 30 million additional Americans into the ranks of those with health insurance in 2014.
Had the Republicans swept the presidency and both houses of Congress (they did maintain a majority in the House of Representatives), an effort to repeal and replace the health care reform legislation would likely have materialized. A protracted battle over the issue would have resulted in a great deal of uncertainty for health care providers, something to which business leaders in any field have an aversion.
As things stand, community pharmacies can increase the scale of their operations to cope with the coming influx of new patients and begin reaching out to people who, because they lack insurance coverage for prescription drugs, are not now regular pharmacy customers. The industry performed particularly well in similar circumstances several years ago when prescription coverage was added to the Medicare program.
The expansion in the number of people with health insurance comes at a propitious moment for pharmacy, which, due to a convergence of factors inside and outside the industry, is in the midst of a fundamental transformation. Stores whose health care activities were largely restricted not all that long ago to dispensing medications and selling over-the-counter pharmaceuticals are now positioned as neighborhood health care centers. Flu shots and other immunizations, routine diagnostic testing, and intensive medication therapy management are quickly becoming the norm.
Pharmacy’s assumption of a more prominent role fits perfectly with the needs of a health care system faced with a growing shortage of primary care physicians. The ease of access and relatively low cost of services offered by the trade class promise to help address two other major concerns.
While the election results provided clarity about the fate of the Affordable Care Act, pharmacy operators can’t be complacent. The rollout of the program will entail myriad decisions that affect the conditions under which care is delivered and how it is paid for. As the roles of providers are redefined and competition for limited resources intensifies, community pharmacy operators will have to demonstrate the value they provide and insist on fair compensation.
The industry has a compelling story to tell about the effectiveness of pharmacy care and its ability to help limit overall health care expenditures. The challenge is to make certain that it is heard and understood.
In addition, pharmacy operators should express their views in the broader debate about economic conditions, including the question of what to do about the looming fiscal cliff. Without an agreement between the president and Congress before the end of the year, the expiration of a number of tax breaks and automatic spending cuts will begin on January 1. Together, they could push the United States back into recession and send the unemployment rate above 9%, according to the Congressional Budget Office.
Pharmacy and health care are an integral part of the overall economy. With so much at stake, it behooves leaders of the industry to weigh in on a problem that could have such a profound impact on their business, their customers and the country as a whole.
